用三焦点牵张成骨技术修复重建颏部骨缺损的实验研究  

Trifocal distraction osteogenesis for the repair of mandibular symphyseal defects in rhesus

作　　者：应彬彬[1] 胡静[1] 李继华[1] 祝颂松[1] 王大章[1] 

机构地区：[1]成都四川大学华西口腔医学院口腔颌面外科,610041

出　　处：《实用口腔医学杂志》2006年第3期295-298,共4页Journal of Practical Stomatology

基　　金：教育部跨世纪优秀人才培养计划(2003教技函)

摘　　要：目的:探讨应用三焦点牵张成骨技术修复重建颏部骨缺损的可行性及其方法。方法:选取4只成年恒河猴,通过下颌前份骨截除术形成颏部正中联合骨缺损。在两侧下颌体部各制备一个输送盘,并用自行研制的可调式多平面牵张装置使双侧输送盘向前内方向缓慢移动,并在颏部正中对接以修复重建颏部骨缺损。通过X线片与螺旋CT三维重建技术检查双侧输送盘移动与新骨形成情况。在牵张结束的第8和16周分别处死2只动物,取下颌骨牵张区标本作组织学检查。结果:牵张结束后,4只恒河猴的颏部形态接近正常猴,X线片与螺旋三维CT片显示两侧输送盘远心端在正中成功对接。牵张结束的第8周,螺旋三维CT与实验组织学观察发现牵张间隙内均有新骨形成;两侧输送盘在下颌正中呈纤维连接,并可见活跃的成骨和改建活动。牵张结束的第16周,牵张间隙内新骨成熟,两侧输送盘下颌正中逐渐呈纤维骨性连接。结论:用可调式多平面牵张装置进行三焦点牵张成骨可以作为修复重建颏部骨缺损的一种选择手段。Objective： To investigate the feasibility of trifocal distraction osteogenesis for the repair of mandibular symphyseal defects in rhesus monkey. Methods： 4 monkeys were used. The mandibular symphyseal defects of 4 monkeys were made by resection of the anterior part ranged from canine to canine of mandible. Bilateral transport disks ranged from first premolar to first molar were created in the remaining mandibular bodies, and a custom-made adjustable multiplanar distraction apparatus was applied to repair the defects by means of trifocal distraction osteogenesis. After a delay period of 7 days, the bilateral transport discs were distracted forward and inward simultaneously. X -ray films and 3- dimmensional CT scan were used to detect the bilateral transport segments movement and the new bone formation. Two monkeys were sacrificed at 8 and 16 weeks respectively after the completion of distraction. The distracted calluses and united areas between bilateral transport discs were harvested and processed for histological examination. Results： After distraction period, the contour of mandible appeared to be similar to the normal. Perfect bone regeneration in the distraction gaps was found, and fibro-bony union between the bilateral transport segments was observed in the midline region 16 weeks after the end of distraction. Conclusion： The technique of trifocal distraction osteogenesis may be an alternative way to repair the mandibular symphseal defects.

关 键 词：牵张成骨 恒河猴 颏部缺损 重建 颏部骨缺损 

分 类 号：R782.2[医药卫生—口腔医学]